Numerous medical monitoring devices are available for monitoring physiological signals in an ambulatory patient. Such devices may be implantable devices, including ECG monitors, hemodynamic monitors, and insulin monitors, or external devices such as Holter monitors. Some devices provided for monitoring physiological signals may also be capable of delivering a therapy to the patient, such as an electrical stimulation therapy or a drug therapy, when the device determines there is a need for therapy based on the monitored physiological signal. Examples of such devices include cardiac pacemakers, implantable cardioverter defibrillators (ICDs), neurostimulators, drug pumps and insulin pumps.
Patients having such devices may be asked by their physician to keep a diary of symptoms associated with a medical condition to aid the physician in identifying the cause of such symptoms using physiological data stored by the monitoring device. Patients may not always be fully compliant in keeping such diaries. Moreover, the task of correlating written records with physiological data stored by the monitoring device can be burdensome.
Some implantable medical device systems include a handheld device operable by the patient to send signals to the implanted device. This handheld device, sometimes referred to as a “patient activator”, allows a patient to transmit a signal to the monitoring device when the patient experiences symptoms relating to a medical condition. Upon receipt of the patient activator signal, the monitoring device may trigger storage of data and/or deliver or adjust a therapy. Typically a patient activator is provided with one or more buttons which the patient depresses to transmit a signal. The specificity of the information transferred to the monitoring device is limited. A signal may be transmitted to the monitoring device indicating that the patient is experiencing a symptom(s) without specific information regarding what symptom(s) were experienced or the severity of such symptoms. Limitations remain in presently available ambulatory patient monitoring systems relating to the recordation of patient symptoms or other handwritten medical data and the integration of such handwritten data with data stored automatically by a monitoring device.